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Substances <br /> • Type A=gasoline, aviation gas, naphtha, denatured ethanol, and hazardous materials, or mixtures or blends <br /> containing such substances <br /> • Type B=diesel, kerosene,jet fuel, crude, fuel oils#1-4,waste oii <br /> • Type C1 =fuel oil#6, low hazard chemicals, process wastewater, asphalt emulsion <br /> . Type C2=asphalt, roofing flux, vegetable oils, sugar beetjuice, paper pulp, other regulated substances <br /> Substance transfer—Other <br /> List one or both or leave blank, as applicable: <br /> • I = impermeable containment area at transfer connection point(give materials of construction and <br /> maximum spill volume contained) <br /> • RT= remote transfers may occur, during which transfers either in or out are initiated, monitored, <br /> terminated, or otherwise controlled from outside of the facility, e.g. interstate pipelines <br /> • RT-UM = remote transfers may occur when the facility is unmanned <br /> Substance Substance Substance Substance OverFill <br /> ' transfer Area transfer transfer transfer prevention Substance <br /> Tank# Gau in name or# methods—In methods—Out area construction s stem transfer—Other <br /> B. Non-Regulated Tanks <br /> List all tanks at the facility greater than 1100 gallons capacity that are not subject to regulation for one of the specific <br /> reasons given below. Tanks must meet the applicable exclusion criteria in Minn. R. ch. 7151.1300. Tanks at the facility <br /> that are not subject to regulation for other reasons, (e.g. tote tanks)need not be listed below. <br /> 1. Tank number or name <br /> Provide a unique number or name for the tank. Tank numbers or names must be keyed to the facility layout. <br /> 2. Contents <br /> Identify the contents of the tank. <br /> 3. Reason for exclusion(choose one): <br /> ❑ Indoor(per Minn. R. 7151.1300, subp. 2.C.) <br /> An indoor tank is one that is located inside of a building, resting on or elevated above an impermeable floor, <br /> from which a release in the amount of the design capacity of the tank would (Identify by letter a/b/c which of the <br /> containment methods applies to the tank.): <br /> a. be entirely contained within a tank-specific secondary containment structure; or <br /> b. would not escape from the building through doorways, floor drains, or by other means; or <br /> c. would be directed by the drainage system of the building either to a permitted on-site wastewater treatment <br /> facility, or to a permitted municipal wastewater treatment facility. <br /> ❑ Wastewater clarifiers, basins, and treatment equipment(per Minn. R. 7151.1300, subp. 2.A.) <br /> ❑ Hazardous waste(per Minn. R. 7151.1300, subp. 2.E.) <br /> ❑ Agricultural chemical(per Minn. R. 7151.1300, subp. 2.F.) <br /> ❑ Stainless steel (per Minn. R. 7151.1300, subp. 2.1.) <br /> ❑ Clean water(per Minn. R. 7151.1300, subp. 2.J.) <br /> ❑ Solid(substance is a solid at ambient temperatures and pressures) <br /> ❑ Gas(substance is a gas at ambient temperatures and pressures) <br /> Tank#or name Contents Reason for exclusion <br /> VII. Secondary Containment <br /> List all secondary containment areas for tanks listed in Part VI.A., including: <br /> Containment area number <br /> Give each area a number. This can be the same number as that of the tank in the area, or one of the tanks if <br /> there are more than one, or another numbering system may be used. Containment area number must be keyed to <br /> facility layout. <br /> t-a3-25 <br /> 4/4/07 Poge 5 of 8 <br />